Cystometry

If you’re having a cystometry test, here’s what you can expect:

Before the Test:

• You may be asked not to pass urine for a few hours before the test so the doctor can see how your bladder works when it’s full.
• The doctor will explain the test to you and answer any questions you might have.

During the Test:

1. Getting Ready: You will lie down on a bed or sit on a special chair. A nurse or doctor will clean the area around your urethra (where urine comes out) to make sure it’s clean.
2. Insertion of a Tube (Catheter): The doctor will gently insert a small, soft tube (called a catheter) into your urethra and into your bladder. You may feel a little discomfort, but it shouldn’t be very painful. Another small catheter will be placed in the rectum or vagina.
3. Filling Your Bladder: The doctor will slowly fill your bladder with a warm, sterile liquid through the catheter. As the bladder fills up, you will be asked how it feels. You might start feeling like you need to pee.
4. Pressure Measurement: The doctor will measure the pressure in your bladder as it fills to see how it responds. You might be asked to cough or change positions while the bladder is being filled.
5. Emptying Your Bladder: Once the bladder is full, you will be asked to empty your bladder (urinate) while the doctor checks how well it empties.

After the Test:

• The catheter will be removed, and you can go back to normal activities.
• It’s normal to feel a little discomfort or have a small amount of urgency to pee right after the test.

The cystometry test helps your health care team figure out how well your bladder is working, especially if you have problems like needing to pee a lot, pain or trouble emptying your bladder. It only takes about 30 minutes and is usually not very painful.

Cystometry in a female patient

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What are results from this test telling you?

The results from a Cystometry (CMG) test help your health care team understand how well your bladder is working. Here’s what the results can tell a patient:

1. Bladder Capacity. The test shows how much urine your bladder can hold before you feel the urge to go to the bathroom. If your bladder holds less than normal, it might mean there’s a problem.
2. Bladder Pressure. The test measures the pressure inside your bladder as it fills. If the pressure gets too high, it might mean the bladder isn't working properly, which can lead to problems like leaks or not being able to hold urine.
3. Bladder Sensitivity. The doctor can see how sensitive your bladder is. If you feel the urge to pass urine too early or very strongly, it might mean the bladder is too sensitive or overactive.
4. How Well the Bladder Empties. The test also checks if the bladder empties properly when you pass urine. If the bladder doesn’t empty all the way, it might cause problems like infections or feeling like you need to go again soon after using the bathroom.
5. Problems with the Urethra. The test can show if there are problems with the tube (urethra) that carries urine out of the bladder. If the urethra is blocked or not working well, it can make it hard to pass urine.

What it Means for You:

• If the test shows that your bladder is too sensitive, overactive or not emptying properly, your health care team might suggest treatments to help.
• If the pressure is too high, your health care team might look for reasons why and discuss ways to reduce the pressure.
• If the bladder can hold less urine than normal, it could explain why you need to go to the bathroom often.

The results help your health care team understand what might be causing your bladder problems, so they can suggest the best treatment for you.

Will I need other tests to explain my problem?

Yes, after a cystometrogram (CMG) test, you might need other tests to help explain your bladder problems more clearly. The CMG gives your health care team important information about how your bladder is working, but sometimes more tests are needed to get a complete picture of what's going on. Here are some tests that could be recommended:

1. Urodynamic Study. A urodynamic study is a group of tests that measure how well your bladder and urethra store and release urine. It can include the cystometrogram (CMG) along with other tests, like:

• Pressure Flow Study: To see how well your bladder empties when you urinate.
• Post-void Residual Measurement: To check if there’s any urine left in your bladder after you pee.

2. Ultrasound. An ultrasound uses sound waves to take pictures of your bladder and kidneys. It can help your health care team see if there are any blockages, kidney problems or other issues causing your symptoms.
3. Urethral Pressure Profile (UPP). This test measures the pressure inside the urethra to see how well it can hold urine. It’s helpful if your health care team thinks there might be problems with the urethra or sphincter muscles (the muscles that control urine flow).
4. Cystoscopy. In this test, a small camera is inserted into your bladder through the urethra. It allows the doctor to look directly inside your bladder to check for any problems like infections, bladder stones or other conditions.
5. MRI or CT Scan. In some cases, an MRI (Magnetic Resonance Imaging) or CT Scan (Computed Tomography) might be done to get detailed images of your bladder and the surrounding organs. These scans can help find any problems that the other tests might not show.

Why More Tests Might Be Needed:

• If the cystometrogram shows unusual results, more tests might help pinpoint the cause.
• If your doctor needs to check for other conditions, such as bladder stones, infections or nerve problems.
• If the cystometrogram results don’t fully explain your symptoms, other tests can give more details.

Your health care team will decide which tests are right for you based on the cystometrogram results and your symptoms. The goal is to find the best way to treat your bladder problem.

What are my next-steps for treatment?

After a cystometrogram (CMG), your next steps for treatment will depend on what the test results show and what symptoms you’re experiencing. Based on the results, your health care team will discuss the best options to help improve your bladder health. Here’s what might happen next:

1. Talking About Your CMG Results. Your health care team will go over the results of your cystometrogram with you. They’ll explain how your bladder is working (or not working) and whether there are any problems, such as:

• High bladder pressure
• Bladder hyperactivity or sensitivity
• Incomplete emptying of the bladder
• Bladder capacity (how much it can hold)

2. Medications. If the cystometrogram shows problems like bladder hyperactivity, your health care team may suggest medicines to help relax the bladder or reduce frequent urges to pass urine. Common medications might include:

• Anticholinergics: These help calm an overactive bladder.
• Beta-3 agonists: These help the bladder hold more urine.
• Alpha-blockers: If there’s an issue with the urethra or prostate (in men), these can help improve urine flow.

3. Behavioral and Lifestyle Changes. Based on your symptoms, your health care team may suggest changes in how you manage your bladder, like:

• Bladder training: This involves learning to wait longer between bathroom trips to improve bladder control.
• Pelvic floor exercises (Kegel exercises): These strengthen the muscles that help control urination and can help if you have bladder leaks or trouble holding urine.
• Fluid management: Adjusting how much you drink or when you drink to help reduce urgency and frequency.

4. Physical Therapy or Biofeedback. If the cystometrogram shows issues with bladder muscle function or coordination, you might be referred for pelvic floor physical therapy. A physical therapist can help you strengthen or relax the muscles that control the bladder.

• Biofeedback: This helps you learn how to control the muscles around your bladder by giving you real-time feedback about how your muscles are working.

5. Further Tests or Imaging. If the cystometrogram shows other issues, such as a blockage, bladder stones or nerve problems, your health care team may suggest more tests or imaging, such as:

• Cystoscopy: To look inside the bladder with a camera.
• Ultrasound: To check for stones or other abnormalities.
• Urodynamic testing: Additional tests to measure bladder pressure and flow.

6. Surgery. In some cases, if there is a serious issue that can’t be fixed with medications or therapy, surgery may be needed. For example:

• If there’s a bladder obstruction or a blockage in the urethra that is causing problems, surgery might be needed to remove the blockage.
• If there is bladder prolapse or a bladder diverticulum, surgery may be used to fix or remove the pouch.

7. Regular Follow-Ups. Your health care team may want to schedule regular check-ups to monitor your bladder health and see how well your treatment is working. They may adjust your treatment plan based on how you're feeling and any new symptoms.
8. Support and Education. Sometimes, living with bladder issues can be frustrating, so your health care team might offer advice on managing symptoms, recommend support groups or provide educational materials to help you understand your condition and treatment options better.

Summary of Next Steps:

1. Review CMG results with your health care team.
2. Discuss treatment options, including medications, therapy or lifestyle changes.
3. Follow-up tests or imaging if needed.
4. Consider surgery if necessary for serious issues.
5. Monitor your progress with regular follow-ups and adjustments.

Your health care team will guide you through these steps and help you find the best plan for your bladder health based on your symptoms and CMG results.

Updated November 2024.